crossing96/oncoscreening huggingface dataset:
Adaptive radiotherapy for invasive bladder cancer: a feasibility study.	PURPOSE: To evaluate the feasibility of adaptive radiotherapy (ART) in combination with a partial bladder irradiation. METHODS AND MATERIALS: Twenty-one patients with solitary T1-T4 N0M0 bladder cancer were treated to the bladder tumor + 2 cm margin planning target volume (PTV(CONV)). During the first treatment week, five daily computed tomography (CT) scans were made immediately before or after treatment. In the second week, a volume was constructed encompassing the gross tumor volumes (GTVs) on the planning scan and the five CT scans (GTV(ART)). The GTV(ART) was expanded with a 1 cm margin for the construction of a PTV(ART). Starting in the third week, patients were treated to PTV(ART). Repeat CT scans were used to evaluate treatment accuracy. RESULTS: On 5 of 91 repeat CT scans (5%), the GTV was not adequately covered by the PTV(ART). On treatment planning, there was only one scan in which the GTV was not adequately covered by the 95% isodose. On average, the treatment volumes were reduced by 40% when comparing PTV(ART) with PTV(CONV) (p < 0.0001). CONCLUSION: The adaptive strategy for bladder cancer is an effective way to deal with treatment errors caused by variations in bladder tumor position and leads to a substantial reduction in treatment volumes.	bladder
Gene expression in normal urothelium depends on location within the bladder: a possible link to bladder carcinogenesis.	OBJECTIVES: Clinical studies have shown that more than 70% of primary bladder tumours arise in the area around the ureteric orifice. In this study a genomic approach was taken to explore the molecular mechanisms that may influence this phenomenon. METHODS: RNA was isolated from each individual normal ureteric orifice and the dome biopsy from 33 male patients. Equal amounts of the pooled ureteric orifice and dome mRNAs were labelled with Cy3 and Cy5, respectively before hybridising to the gene chip (UniGEM 2.0, Incyte Genomics Inc., Wilmington, Delaware, USA). RESULTS: Significant changes (more than a twofold difference) in gene expression were observed in 3.1% (312) of the 10,176 gene array: 211 genes upregulated and 101 downregulated. Analysis of Cdc25B, TK1, PKM, and PDGFra with RT-PCR supported the reliability of the microarray result. Seladin-1 was the most upregulated gene in the ureteric orifice: 8.3-fold on the microarray and 11.4-fold by real time PCR. CONCLUSIONS: Overall, this study suggests significant altered gene expression between these two anatomically distinct areas of the normal human bladder. Of particular note is Seladin-1, whose significance in cancer is yet to be clarified. Further studies of the genes discovered by this work will help clarify which of these differences influence primary bladder carcinogenesis.	bladder
Urogenital carcinogenesis in female CD1 mice induced by in utero arsenic exposure is exacerbated by postnatal diethylstilbestrol treatment.	Transplacental inorganic arsenic carcinogenicity, together with postnatal exposure to diethylstilbestrol or tamoxifen, was studied. Pregnant CD1 mice received 85 ppm arsenic in the drinking water from gestation days 8 to 18 and were allowed to give birth. Groups (n = 35) of female offspring were injected s.c. on postpartum days 1 through 5 with diethylstilbestrol (2 microg/pup/d) or tamoxifen (10 microg/pup/d) and observed for 90 weeks. Arsenic alone induced some urogenital system tumors, including mostly benign tumors of the ovary and uterus, and adrenal adenoma. Diethylstilbestrol alone induced some tumors (primarily cervical) but when given after in utero arsenic, it greatly enhanced urogenital tumor incidence, multiplicity, and progression. For instance, compared with the incidence of urogenital malignancies in the control (0%), arsenic alone (9%), and diethylstilbestrol alone (21%) groups, arsenic plus diethylstilbestrol acted synergistically, inducing a 48% incidence of malignant urogenital tumors. Of the urogenital tumors induced by arsenic plus diethylstilbestrol, 80% were malignant, and 55% were multiple site. Arsenic plus diethylstilbestrol increased ovarian, uterine, and vaginal tumors, and urinary bladder proliferative lesions, including three transitional cell carcinomas. Tamoxifen alone did not increase urogenital tumors or affect arsenic-induced neoplasia but did increase arsenic-induced uroepithelial proliferative lesions. Uterine and bladder carcinoma induced by arsenic plus diethylstilbestrol greatly overexpressed estrogen receptor-alpha (ER-alpha) and pS2, an estrogen-regulated gene. In neonatal uteri, prenatal arsenic increased ER-alpha expression and enhanced estrogen-related gene expression induced by postnatal diethylstilbestrol. Thus, arsenic acts with estrogens to enhance production of female mouse urogenital cancers.	bladder
Well water radioactivity and risk of cancers of the urinary organs.	Water from bedrock frequently contains higher concentrations of natural radionuclides than water from other sources. Bladder and kidneys receive a radiation dose when radioactive isotopes are excreted into urine. The subjects for this case-cohort study were selected from all drilled wells users in Finland. The study comprised 61 bladder cancer and 51 kidney cancer cases diagnosed between 1981 and 1995, as well as a random sample of 274 reference persons, stratified by age and sex. The median activity concentrations of radon in drilled wells used by bladder and kidney cancer cases and the reference cohort were 170, 140, and 130 Bq/L, respectively. The radium concentration was 0.01 Bq/L for all groups and the uranium concentrations were 0.08, 0.07, and 0.06 Bq/L, respectively. The bladder cancer risks associated with radon, radium, and uranium activity concentrations in drinking water were 1.02 (0.68-1.54) per log(100 Bq of radon/L), 0.73 (0.21-2.50) per log(0.1 Bq of radium/L), and 0.77 (0.32-1.89) per log(1 Bq of uranium/L). The corresponding figures for kidney cancer were 0.81 (0.47-1.37), 0.12 (0.01-1.10), and 0.92 (0.36-2.35), respectively. In conclusion, even though ingested radionuclides from drilled wells are a source of radiation exposure, they are not associated with a substantially increased risk of bladder or kidney cancers in concentrations occurring in drilled wells.	bladder
Establishment and characterization of human urothelial cancer xenografts in severe combined immunodeficient mice.	AIM: To establish and characterize a murine xenograft model of human urothelial cancer in severe combined immunodeficient (SCID) mice for therapeutic simulation. METHODS: Pieces of 30 freshly resected urothelial tumors (24 obtained from bladder and 6 from ureter or pelvis) were implanted subcutaneously into SCID mice, and xenograft tumors were passed in tumorigenic cases. At each passage, histopathology, TP53 mutational status assessed by yeast p53 functional assay, and the Ki-67 labeling index (LI) were examined to evaluate the preservation of original features. A growth delay assay after single-dose irradiation was performed in four representative xenografts. RESULTS: Tumor growth was observed in 18 mice (60%, 18/30). Histologically, 15 of the 18 were epithelial carcinomas similar to the original tumors, whereas the other 3 were Epstein-Barr virus-associated lymphoproliferative disease, resulting in a 50% (15/30) take rate. No correlation was found between the tumor take rate and the clinicopathologic features, TP53 mutational status, or Ki-67 LI of the patients' tumors. Of these 15 xenografts, 11 xenografts were passed from 3 to 10 generations. TP53 mutational status remained stable during the passages, and the Ki-67 LI of eight xenografts was within a range of 50% of the LI of the original tumors, although the other three xenografts increased by over 50%. Specific growth delay after irradiation, independent of the original tumor growth speed and Ki-67 LI, was observed in four xenografts. CONCLUSIONS: SCID mice are useful recipients for investigations of human urothelial cancer with a wide biological range. This easy-to-handle xenograft system can help to develop a better in vivo preclinical evaluation system for therapeutic agents as well as the investigation of tumor pathophysiology.	bladder
Conservative treatment of high grade superficial bladder tumours.	AIM OF THE STUDY: To review our previous experience in the treatment of high grade superficial bladder tumour. MATERIAL AND METHODS: Data from 71 consecutive patients (12 women and 59 men) with high grade (G3) superficial (Ta-T1) bladder tumour were considered. After endoscopic treatment 31 patients received intravesical immunotherapy with Bacillus Calmette Guerin (BCG), 14 patients were treated with a combined scheme of intravesical chemotherapy and immunotherapy and respectively 3 patients and one patient with intravesical chemotherapy with mitomycin (MMC) or epirubicin (EPI) alone. A group of 16 patients received no further treatment after TUR and other 6 patients was treated with systemic chemotherapy or radiotherapy. Patients were followed up with urine cytology and cystoscopy every three months, renal sonography every six months and intravenous pyelography every 2 years or in the case of positive cytology associated with negative cystoscopy. RESULTS: Out of 16 patients treated with TUR alone 11 recurred (69%) BCG was initiated in 31 patients and 12 out of them suffered recurrences (42%), whereas 7 out of 14 patients who had combined epirubicin/BCG therapy developed recurrences (50%). Out of 19 patients who recurred after treatment with BCG alone or combined with epirubicin, five underwent immediate cystectomy and other five delayed cystectomy after a second course of intravesical therapy. In the latter group higher pathological stages were observed. We were not able to identify any factor predictive of recurrence after BCG treatment: sex (M 16/40 vs F 3/5 p = 0.35), stage (Ta 1/6 vs T1 18/39 p = 0.11), associated carcinoma in situ (CIS) (No CIS 1/8 vs CIS 18/37 p = 0.11), multifocal (single 13/31 vs multiple 6/14 p = 1.00), age (66.8 +/- 7.8 vs 62.9 +/- 11.9 years p = 0.19) and number of previous recurrences (0.42 +/- 0.90 vs 1.31 +/- 2.16 p = 0.06). Under chemotherapy (MMC or EPI) all 4 treated patients suffered recurrences (100%). Out of all recurrent patients after conservative treatment of an high grade superficial bladder tumours, seven presented tumours with a low grade histology (downgrading). In all but one of these patients an high grade tumour recurred within 30 months. CONCLUSIONS: The adoption of a correct strategy of intravesical metaphylaxis with BCG allows to spare cistectomy in up to 60% of the patients with high grade superficial bladder carcinoma and the optimisation of treatment protocols will lead to even more effective results. However this tumour still demands the highest level of attention in the follow up and in the case of recurrence primary conservative treatment with BCG should be promptly converted to radical surgical treatment considering that the development of less invasive surgical procedures has reduced the impact on the patient's quality of life	bladder
Working capacity and well-being after radical cystectomy with continent cutaneous diversion.	OBJECTIVES: The primary aim was to compare the working capacity in patients with continent urinary diversion with a control group. Secondary aims were to assess the changes in electrolyte and acid-base homeostasis and the functional status during strenuous physical activity, and finally, the well-being in the two groups. METHODS: Eleven patients who had undergone radical cystectomy and continent cutaneous diversion using an ileocolonic segment participated. The control group consisted of 12 men, matched for age and activity level. Working capacity was assessed by ergospirometry on an exercise bicycle. Venous blood samples were taken before the test, when the expiratory exchange ratio (RER) was about 1.0 and immediately after completion of the test. SF-36 was used to evaluate the subject's functional status and well-being. RESULTS: The median working capacity in the patient group was 155 (85-190) W and 155 (125-215) W in the control group (n.s.) corresponding to 72 (43-97) % and 80 (59-97) % respectively of predicted values. Peak oxygen uptake was somewhat low in both groups when compared to P-O Astrands norms. Blood tests revealed that patients developed a slight metabolic hyperchloremic acidosis, not seen in the control group. There were no differences between the groups as assessed with SF-36. CONCLUSION: Patients with a continent urinary diversion have a working capacity equal to a control group despite a slight metabolic hyperchloremic acidosis. Quality of life was similar in the two groups and corresponded well with the norms for the general Swedish population aged 65 to 74.	bladder
[Geriatric urology -- tumour diseases].	Due to demographic developments malignancies of urogenital origin will gain increasing importance. The urologist will face a growing group of patients with co-morbidities and functional disabilities as these neoplasms increase with age. Optimisation of peri-interventional management successfully reduces the risks of surgery. Integration of taxane-based cytostatic regimes achieves a prolongation of survival in hormone-refractory metastatic prostatic cancer. The introduction of gemcitabine in the management of malignancies of the bladder seems to have reduced toxicity while maintaining anti-tumour activity in comparison to MVAC. The role of haematopoetic growth factors remains to be defined in urologic malignancies - increasing dose intensity for better activity or reduction of toxicity. Individualisation of treatment requires early cooperation of the urologist, the oncologist and the geriatrician for an optimal outcome.	bladder
The distribution pattern of myofibroblasts in the stroma of human bladder carcinoma depends on their invasiveness.	The presence of myofibroblasts has been elucidated in the stroma of neoplasm of various organs. In the present article, we studied the distribution of myofibroblasts in the stroma of bladder carcinoma. Twenty-five surgical resected bladder tumors (urothelial carcinoma, n = 21; combined urothelial carcinoma and adenocarcinoma, n = 2; sarcomatoid squamous cell carcinoma, n = 1; combined urothelial carcinoma and squamous cell carcinoma, n = 1) were selected and we evaluated the distribution of myofibroblasts using immunohistochemical, electron and immunoelectron microscopic techniques. Immunohistochemically, the distribution pattern of myofibroblasts in invasive and non-invasive carcinomas were predominantly fascicular and reticular forms, respectively. Moreover, myofibroblasts around bladder carcinoma cells were confirmed by electron microscope. Understanding the distribution pattern of myofibroblasts in the stroma of bladder carcinoma may provide available information about the presence of carcinoma invasion.	bladder
[Bladder leiomyoma. A case report and literature review].	OBJECTIVES: To report a new case of bladder leiomyoma. METHODS: A 20 mm tumor of the right lateral wall of the bladder was incidentally found in a pelvic ultrasound study of a 29-year-old female. The cystogram showed the presence of a filling defect in the same side. Cystoscopy showed a right lateral wall tumor with normal mucosal cover. RESULTS: With the working diagnosis of bladder leiomyoma, transurethral resection of the bladder tumor was performed, and pathology confirmed the diagnosis. Postoperatively, the patient developed a calcareous plaque on the resection area which was treated by transurethral resection of the plaque and leiomyoma remainders and subsequence urine acidification. CONCLUSION: Although it is a rare tumor, in certain circumstances it is possible to establish the working preoperative diagnosis with a high index of suspicion. On the other hand, due to the benign character of the process, conservative surgery (transurethral resection in this case) offers excellent results.	bladder
[Cholesterol embolism of the upper urinary tract as a clinical feature of atherosclerotic embolic vascular disease. Report of three cases, one of them simulating neoplasia].	OBJECTIVES: To report three cases of atherosclerotic embolic vascular disease with clinical presentation in the lower urinary tract. This disease is not frequent; it mainly affects the skin, kidneys and skeletal muscle. Other organs of the urinary tract are rarely affected and they are exceptionally the clinical site of debut without previous known involvement of other areas. METHODS/RESULTS: The first patient presented with hematuria associated with an ultrasound/cystoscopical image suspicion for neoplasia. Pathologic report of the transurethral resection chips showed polypoid cystitis with some small size arteries occupied by cholesterol needles, associated with inflammation, ulcers and hematic extravasation. The second patient underwent cystoprostatectomy for a transitional cell carcinoma and, incidentally, numerous cholesterol emboli were found, mainly in the lamina propria, but also in other layers of the bladder wall, prostate, urethra, veru montanum, and one seminal vesicle; this two latter sites have not being reported in previous publications. The third patient showed the embolus within a prostate biopsy core. CONCLUSIONS: This unfrequent disease may present as a bladder or prostatic process and be diagnosed by biopsy of these organs. It may simulate a bladder neoplasia on ultrasound or cystoscopy and should be included among related or etiologic entities of polypoid cystitis, a well-known simulator of neoplasia.	bladder
[Bladder leiomyoma treated by transurethral endoscopic resection].	We report a case of intravesical bladder leiomyoma in a 47-year-old patient presenting with recurrent macroscopic haematuria. The diagnosis was strongly suspected on CT and cystoscopy. Treatment consisted of transurethral resection of the mass. No recurrence has been observed with a follow-up of two years. In the light of this case, the authors discuss the diagnosis and treatment of bladder leiomyoma.	bladder
[Transitional cell carcinoma involvement of the prostate].	"Transitional cell carcinoma of the prostate (PTCC) has become a well recognized entity and is increasing in incidence due to the growing awareness of and search for. PTCC is part of the well known pan-urothelial disease: particularly the urologist must always consider the prostate in the management of superficial and invasive bladder cancer. Most cases are diagnosed in association with bladder cancer (secondary PTCC): primary prostatic transitional cell carcinoma arises ""de novo"" as the first tumor of the prostate urothelium and is rare. Prognosis depends on the prostate invasion degree. No reliable staging system is presently available. Non-invasive PTCC can be successfully treated with conservative means (TUR +/- BCG) whereas stromal invasive PTCC must be aggressively treated with radical cystectomy. PTCC can interphere with surgeon's decisions about urinary diversion in patients undergoing radical cystectomy for urothelial cancer."	bladder
Differential requirement for DNA methyltransferase 1 in maintaining human cancer cell gene promoter hypermethylation.	Previous work has shown that DNA hypermethylation of tumor suppressor genes in colorectal cancer cells may be maintained in the absence of the major mammalian methyltransferase, DNA methyltransferase 1 (DNMT1). In an effort to dissect the dependency on DNMT1 to maintain such hypermethylation in different cancer types, we performed a systematic analysis of depletion of DNMT1 in colorectal (SW48), bladder (T24), and breast (T47D) cancer cells by DNMT1-specific small hairpin RNA (shRNA) targeting. We show that although DNMT1-deficient SW48 and T24 cells exhibited no observable growth defects and were able to maintain promoter hypermethylation, DNMT1-deficient T47D breast cells failed to form comparable numbers of colonies when stably selected for the incorporation of the DNMT1-specific shRNA expression vector, suggesting a growth defect with reduced levels of DNMT1. Further treatment of T47D cells with transient transfection of small interfering RNA targeting DNMT1 revealed that severely DNMT1-deficient T47D cells could not fully maintain promoter hypermethylation, and gene silencing was partially reversed at two of the three assayed loci. These observations suggest that human cancer cells may differ in their reliance on DNMT1 for maintaining DNA methylation.	bladder
Bladder cancer risk in sales workers: artefact or cause for concern?	BACKGROUND: A large number of epidemiological studies have reported positive associations between bladder cancer and sales occupations. We investigated whether these findings are likely to be due to chance, confounding or publication bias, or may involve causal associations. METHODS: Studies reporting bladder cancer risk-estimates for sales occupations were reviewed. Using meta-analyses we assessed heterogeneity and publication bias, and derived summary estimates. RESULTS: Eighteen publications were identified, reporting 85 risk-estimates for sales-work. Meta-estimates were elevated for men (odds ratio (OR) 1.11, 95% confidence interval (CI) 1.01-1.21) and women (OR = 1.36, 95% CI = 1.11-1.67). The estimate was heterogeneous for men (p(Q-test) <0.01, women: 0.18) and indicated publication bias for women (p(Egger-test) <0.01, men: 0.40). When including only smoking-adjusted estimates reported irrespective of the strength of the association, the summary estimate for generic groups of sales workers was 0.99 (95% CI 0.90-1.08) for men, and 1.18 (95% CI = 0.99-1.39) for women, without statistically significant heterogeneity or publication bias. For women, risk was positively associated with longer duration of sales-employment in three studies. CONCLUSIONS: Publication bias explained most of the reported increased bladder cancer risk, but sales-work still appeared to be associated with a small risk in women. Possible causal factors include lower frequency of urination and reduced fluid intake.	bladder
Surveillance for recurrent bladder cancer using a point-of-care proteomic assay.	CONTEXT: At least 50% of patients with a history of bladder cancer have recurrences, so rigorous surveillance is necessary. Cystoscopy is standard but can fail to detect some bladder cancers, so a urine test is frequently part of the evaluation. OBJECTIVE: To investigate whether a point-of-care proteomic test that measures the nuclear matrix protein NMP22 in voided urine could improve detection of recurrence during monitoring of patients with a history of bladder cancer. DESIGN, SETTING, AND PATIENTS: From September 2001 to February 2002, 23 academic, private practice, and hospital facilities in 9 US states prospectively enrolled 668 consecutive patients with a history of bladder cancer in this cross-sectional study. Patients provided a voided urine sample for analysis of NMP22 protein and cytology prior to cystoscopy. MAIN OUTCOME MEASURES: Diagnosis of bladder cancer recurrence, based on cystoscopy with biopsy, was accepted as the reference standard. The performance of the NMP22 test was compared with voided urine cytology as an aid to detection. Testing for the NMP22 tumor marker was conducted in a blinded manner. RESULTS: Bladder cancer was diagnosed in 103 patients. Cystoscopy alone identified 91.3% of the cancers (94/103; 95% confidence interval [CI], 84.1%-95.9%). The combination of cystoscopy with the NMP22 assay detected 99.0% of the malignancies (102/103; 95% CI, 94.7%-100%; P = .005). The NMP22 assay detected 8 of 9 cancers that were not visualized during initial cystoscopy, including 7 that were high-grade. The sensitivity and specificity of the NMP22 test alone were 49.5% (51/103; 95% CI, 39.5%-59.5%) and 87.3% (493/565; 95% CI, 84.2%-89.9%), respectively. Voided cytology detected only 3 of the malignancies missed during initial cystoscopy and did not significantly increase the sensitivity of cystoscopy (94.2%; 95% CI, 87.7%-97.8%; P = .08). CONCLUSION: The noninvasive point-of-care assay for elevated urinary NMP22 protein can increase the ability to detect recurrent bladder cancer, with test results available during the patient visit.	bladder